Supplemental Budget Neutrality Test. New Adult Group. Adults eligible for Medicaid as the group defined in section 1902(a)(10)(A)(i)(VIII) of the Act are included in this demonstration, and in the budget neutrality. The state will not be allowed to obtain budget neutrality “savings” from this population. Therefore, a separate expenditure cap is established for this group, to be known as Supplemental Budget Neutrality Test. The EG listed in the table below is included in Supplemental Budget Neutrality Test. Eligibility Group (EG) Trend Rate DY 21 PMPM (SFY 2018) DY 22 PMPM (SFY 2019) DY 23 PMPM (SFY 2020) DY 24 PMPM (SFY 2021) DY 25 PMPM (SFY 2022) New Adult Group 4.3 percent $561.68 $585.83 $611.02 $637.29 $664.70 If the state’s experience of the take up rate for the New Adult Group and other factors that affect the costs of this population indicates that the PMPM limit described above in paragraph (a) may underestimate the actual costs of medical assistance for the New Adult Group, the state may submit an adjustment to paragraph (a) for CMS review without submitting an amendment. Adjustments to the PMPM limit for a demonstration year must be submitted to CMS by no later than April 30 of the demonstration year for which the adjustment would take effect. The Supplemental Budget Neutrality Test is calculated by taking the PMPM cost projection for the New Adult Group in each DY, times the number of eligible member months for that group and DY, and adding the products together across groups and DYs. The federal share of the Supplemental Cap is obtained by multiplying total computable Supplemental Cap by the Composite Federal Share described in STC 112. The Supplemental Budget Neutrality Test is a comparison between the federal share of the Supplemental Cap and total FFP reported by the State for the New Adult Group. If total FFP for the New Adult Group should exceed the federal share of the Supplemental Budget Neutrality Test after any adjustments made to the budget neutrality limit as described in paragraph (b), the difference must be reported as a cost against the budget neutrality limit described in STC 108. Early Periodic Screening, Diagnosis, and Treatment (EPSDT) adjustment. The Commonwealth must present to CMS for approval a draft evaluation plan outlining the methodology to track the following: Baseline measurement of EPSDT service utilization prior to the EPSDT court- ordered remedial plan in Xxxxx X. v Xxxxxx (the Order) final judgment and final remedial plan established on July 16, 200...
Supplemental Budget Neutrality Test. New Adult Group. Adults eligible for Medicaid as the group defined in section 1902(a)(10)(A)(i)(VIII) of the Act are included in this demonstration, and in the budget neutrality. The state will not be allowed to obtain budget neutrality “savings” from this population. Therefore, a separate expenditure cap is established for this group, to be known as Supplemental Budget Neutrality Test.
